结直肠无蒂型锯齿状腺瘤检出率及其相关影响因素
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摘要
目的探讨结直肠无蒂型锯齿状腺瘤(SSA)检出率及其相关影响因素。方法收集2017年1-12月于本院接受肠镜检查的11 345例患者的临床资料进行回顾性分析,计算SSA检出率,采用Logistic回归分析影响SSA检出率的独立相关因素。结果 11 345例患者临床资料进入筛选,最后纳入7 733例患者,其中男性4 655例,女性3 078例,平均年龄(58.2±8.3)岁;7 733例患者检出息肉者1 678例(2 918枚),息肉检出率为21.70%,其中SSA检出76例(86枚),检出率为0.98%,息肉构成比占4.53%。单因素分析结果显示,肠道清洁度、退镜时间、息肉大小、腺瘤检出率与SSA检出率相关(P<0.05),多因素分析结果显示,腺瘤检出率是SSA检出率的独立预测因子(P<0.05)。结论结直肠腺瘤的患者并发SSA风险更高,临床医生应加强对此类病变的警惕性。
Objective To discuss the detection rate and risk factors of colorectal sessile serrated adenoma(SSA).Methods Overall 11 345 patients who received colonoscopy in our hospital from January 2017 to December 2017 were recruited into this study. The clinical data was retrospective analysed; the detection rate of SSA was counted,and the risk factors of SSA were analysed through Logistic regression. Results The clinical data of 11 345 patients were screened, and7 733 patients were enrolled, including 4 655 males and 3 078 females,with an average age of( 58.2±8.3) years. Among 7 733 patients, 1 678 cases(2 918 polyps) were detected, and the detection rate of polyp was 21.70%, among which SSA were found in 76 cases(86 polyps), and the detection rate was 0.98%, and the proportion of polyp was 4.53%. Logistic regression analysis and single factor analysis results showed that the intestinal cleanliness, mirror back time, polyp size,adenomatous polyp detection rate were related with the SSA detection rate(P<0.05), and multi-factor analysis showed that adenoma detection rate was an independent predictor of SSA detection rate( P<0.05). Conclusion Patients with colorectal adenomas are at higher risk of concurrent SSA, and clinicians should enhance their vigilance against such lesions.
Objective To discuss the detection rate and risk factors of colorectal sessile serrated adenoma(SSA).Methods Overall 11 345 patients who received colonoscopy in our hospital from January 2017 to December 2017 were recruited into this study. The clinical data was retrospective analysed; the detection rate of SSA was counted,and the risk factors of SSA were analysed through Logistic regression. Results The clinical data of 11 345 patients were screened, and7 733 patients were enrolled, including 4 655 males and 3 078 females,with an average age of( 58.2±8.3) years. Among 7 733 patients, 1 678 cases(2 918 polyps) were detected, and the detection rate of polyp was 21.70%, among which SSA were found in 76 cases(86 polyps), and the detection rate was 0.98%, and the proportion of polyp was 4.53%. Logistic regression analysis and single factor analysis results showed that the intestinal cleanliness, mirror back time, polyp size,adenomatous polyp detection rate were related with the SSA detection rate(P<0.05), and multi-factor analysis showed that adenoma detection rate was an independent predictor of SSA detection rate( P<0.05). Conclusion Patients with colorectal adenomas are at higher risk of concurrent SSA, and clinicians should enhance their vigilance against such lesions.
引文
[1]邵仟仟,林国乐.2017.V1版《NCCN结直肠癌诊治指南》更新解读[J].中国全科医学,2017,20(6):635-638.
[2]黄秋驰,叶丁,蒋曦依,等.人群结直肠癌筛检项目成本效果分析与评价[J].中华流行病学杂志,2017,38(1):43-45.
[3]Lieberman DA,Rex DK,Winawer SJ,et al.Guidelines for colonoscopy surveillance after screening and polypectomy:a consensus update by the US Multi-Society Task Force on Colorectal Cancer[J].Gastroenterology,2012,143(3):844-857.
[4]Zauber AG,Winawer SJ,O′Brien MJ,et al.Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths[J].N Engl J Med,2012,366(8):687-696.
[5]Rex DK,Schoenfeld PS,Cohen J,et al.Quality indicators for colonoscopy[J].Gastrointest Endosc,2015,81(1):31-53.
[6]Yamane L,Scapulatempo-Neto C,Reis RM,et al.Serrated pathway in colorectal carcinogenesis[J].World J Gastroenterol,2014,20(10):2634-2640
[7]Saiki H,Nishida T,Yamamoto M,et al.Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection[J].Endosc Int Open,2016,4(4):E451-E458.
[8]Urbanski SJ,Kossakowska AE,Marcon N,et al.Mixed hyperplastic adenomatous polyps--an underdiagnosed entity.Report of a case of adenocarcinoma arising within a mixed hyperplastic adenomatous polyp[J].Am J Surg Pathol,1984,8(7):551-556.
[9]Longacre TA,Fenoglio-Preiser CM.Mixed hyperplastic adenomatous polyps/serrated adenomas:a distinct form of coloreetal neoplasia[J].Am J Surg Pathol,1990,14(6):524-537.
[10]Torlakovic E,Skovlund E,Snover DC,et al.Morphologic reappraisal of serrated colorectal polyps[J].Am J Surg Pathol,2003,27(1):65-81.
[11]Ohki D,Tsuji Y,Shinozaki T,et al.Sessile serrated adenoma detection rate is correlated with adenoma detection rate[J].World J Gastrointest Oncol,2018,10(3):82-90.
[12]Ross WA,Thirumurthi S,Lynch PM,et al.Detection rates of premalignant polyps during screening colonoscopy:time to revise quality standards[J]?Gastrointest Endosc,2015,81(3):567-574.
[13]Huang CS,Obrien MJ,Yang S,et al.Hyperplastic polyps,serrated adenom as,and the serrated polyp neoplasia pathway[J].Am J Gastroenterol,2004,99(11):2242-2255.
[14]Zorzi M,Senore C,Da Re F,et al.Detection rate and predictive factors of sessile serrated polyps in an organized colorectal cancer screening programme with immunochemical faecal occult blood test:the EQuIPE study(Evaluating Quality Indicatorsof the Performance of Endoscopy)[J].Gut,2017,66(7):1233-1240.
[15]张婉雯,任宝军,童华生,等.结直肠锯齿状腺瘤内镜和病理形态特征分析[J].中华消化内镜杂志,2006,23(2):81-85.
[2]黄秋驰,叶丁,蒋曦依,等.人群结直肠癌筛检项目成本效果分析与评价[J].中华流行病学杂志,2017,38(1):43-45.
[3]Lieberman DA,Rex DK,Winawer SJ,et al.Guidelines for colonoscopy surveillance after screening and polypectomy:a consensus update by the US Multi-Society Task Force on Colorectal Cancer[J].Gastroenterology,2012,143(3):844-857.
[4]Zauber AG,Winawer SJ,O′Brien MJ,et al.Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths[J].N Engl J Med,2012,366(8):687-696.
[5]Rex DK,Schoenfeld PS,Cohen J,et al.Quality indicators for colonoscopy[J].Gastrointest Endosc,2015,81(1):31-53.
[6]Yamane L,Scapulatempo-Neto C,Reis RM,et al.Serrated pathway in colorectal carcinogenesis[J].World J Gastroenterol,2014,20(10):2634-2640
[7]Saiki H,Nishida T,Yamamoto M,et al.Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection[J].Endosc Int Open,2016,4(4):E451-E458.
[8]Urbanski SJ,Kossakowska AE,Marcon N,et al.Mixed hyperplastic adenomatous polyps--an underdiagnosed entity.Report of a case of adenocarcinoma arising within a mixed hyperplastic adenomatous polyp[J].Am J Surg Pathol,1984,8(7):551-556.
[9]Longacre TA,Fenoglio-Preiser CM.Mixed hyperplastic adenomatous polyps/serrated adenomas:a distinct form of coloreetal neoplasia[J].Am J Surg Pathol,1990,14(6):524-537.
[10]Torlakovic E,Skovlund E,Snover DC,et al.Morphologic reappraisal of serrated colorectal polyps[J].Am J Surg Pathol,2003,27(1):65-81.
[11]Ohki D,Tsuji Y,Shinozaki T,et al.Sessile serrated adenoma detection rate is correlated with adenoma detection rate[J].World J Gastrointest Oncol,2018,10(3):82-90.
[12]Ross WA,Thirumurthi S,Lynch PM,et al.Detection rates of premalignant polyps during screening colonoscopy:time to revise quality standards[J]?Gastrointest Endosc,2015,81(3):567-574.
[13]Huang CS,Obrien MJ,Yang S,et al.Hyperplastic polyps,serrated adenom as,and the serrated polyp neoplasia pathway[J].Am J Gastroenterol,2004,99(11):2242-2255.
[14]Zorzi M,Senore C,Da Re F,et al.Detection rate and predictive factors of sessile serrated polyps in an organized colorectal cancer screening programme with immunochemical faecal occult blood test:the EQuIPE study(Evaluating Quality Indicatorsof the Performance of Endoscopy)[J].Gut,2017,66(7):1233-1240.
[15]张婉雯,任宝军,童华生,等.结直肠锯齿状腺瘤内镜和病理形态特征分析[J].中华消化内镜杂志,2006,23(2):81-85.
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